@article{ref1,
title="High-volume repeaters of self-harm",
journal="Crisis",
year="2016",
author="Ness, Jennifer and Hawton, Keith and Bergen, Helen and Waters, Keith and Kapur, Navneet and Cooper, Jayne and Steeg, Sarah and Clarke, Martin",
volume="37",
number="6",
pages="427-437",
abstract="BACKGROUND: Repetition of self-harm is common and is strongly associated with suicide. Despite this, there is limited research on high-volume repetition. <br><br>AIM: To investigate individuals with high-volume repeat self-harm attendances to the emergency department (ED), including their patterns of attendance and mortality. <br><br>METHOD: Data from the Multicentre Study of Self-Harm in England were used. High-volume repetition was defined as ⩾15 attendances within 4 years. An attendance timeline was constructed for each high-volume repeater (HVR) and the different patterns of attendance were explored using an executive sorting task and hierarchical cluster analysis. <br><br>RESULTS: A small proportion of self-harm patients are HVRs (0.6%) but they account for a large percentage of self-harm attendances (10%). In this study, the new methodological approach resulted in three types of attendance patterns. All of the HVRs had clusters of attendance and a greater proportion died from external causes compared with non-HVRs. <br><br>CONCLUSION: The approach used in this study offers a new method for investigating this problem that could have both clinical and research benefits. The need for early intervention is highlighted by the large number of self-harm episodes per patient, the clustered nature of attendances, and the higher prevalence of death from external causes.<p /> <p>Language: en</p>",
language="en",
issn="0227-5910",
doi="10.1027/0227-5910/a000428",
url="http://dx.doi.org/10.1027/0227-5910/a000428"
}